Serum adiponectin and coronary heart disease risk in older Black and White Americans
Serum adiponectin and coronary heart disease risk in older Black and White Americans
复制标题
DOI：
10.1210/jc.2006-0107
复制
发表时间：
2006-12-01
影响因子：
5.8
通讯作者：
Cummings, Steve R.
中科院分区：
文献类型：
--
作者：
Kanaya, Alka M.;Fyr, Christina Wassel;Cummings, Steve R.
内容：脂联素可能独立于传统的心血管危险因素而影响冠心病（CHD）的风险。目的：由于身体成分和脂联素水平因种族而异，我们在一个老年黑人和白色人队列中研究脂联素与CHD患病率和发病率的关系。S.临床中心。参与者：参与者包括3075名年龄在70岁和79岁之间的功能良好的成年人，他们参加了健康、衰老和身体组成的研究。主要结果测量：冠心病流行的定义为心肌梗死、冠状动脉旁路移植术、经皮冠状动脉腔内血管成形术、心绞痛或主要心电图异常的病史。在排除那些有冠心病的患者后，冠心病事件被定义为住院心肌梗死或冠心病死亡。在6年的随访中，发生了262例（10.6%）冠心病事件。白人的脂联素中位数高于黑人（12 vs. 8 μ g/ml，P < 0.001）。种族改变了脂联素的作用（对于冠心病的流行，P = 0.002，对于冠心病的偶发，P = 0.02）。在白人中，高密度脂蛋白和葡萄糖可以解释脂联素与冠心病的负相关。在黑人中，脂联素加倍与40%的冠心病风险增加相关，（比值比，1.41; 95%置信区间，1.11-1.78）和冠心病事件（风险比，1.37; 95%可信区间，1.01-1.87）。结论：高脂联素循环浓度与老年黑人冠心病的高风险相关，即使是传统的冠心病危险因素。
Context: Adiponectin may influence the risk of coronary heart disease (CHD) independently of traditional cardiovascular risk factors.Objective: Because body composition and adiponectin levels vary by race, we examined the relationship of adiponectin with prevalent and incident CHD in a cohort of older Black and White adults.Design and Setting: We conducted a cross-sectional and prospective cohort study at two U. S. clinical centers.Participants: Participants included 3075 well-functioning adults between ages 70 and 79 yr enrolled in the Health, Aging, and Body Composition study.Main Outcome Measures: Prevalent CHD was defined as history of myocardial infarction, coronary artery bypass graft, percutaneous coronary transluminal angioplasty, angina, or major electrocardiogram abnormalities. After excluding those with prevalent CHD, incident CHD was defined as hospitalized myocardial infarction or CHD death.Results: At baseline, 602 participants (19.6%) had CHD. During 6 yr of follow-up, 262 (10.6%) incident CHD events occurred. Whites had higher median adiponectin than Blacks (12 vs. 8 mu g/ml, P < 0.001). Race modified the effect of adiponectin (P for interaction was 0.002 for prevalent CHD, and P = 0.02 for incident CHD). Among Whites, an inverse association of adiponectin with CHD was explained by high-density lipoprotein and glucose. Among Blacks, a doubling of adiponectin was associated with a 40% higher risk of both prevalent CHD (odds ratio, 1.41; 95% confidence interval, 1.11-1.78) and incident CHD (hazards ratio, 1.37; 95% confidence interval, 1.01-1.87) after adjusting for explanatory variables.Conclusion: High circulating concentrations of adiponectin were associated with higher risk of CHD in older Blacks, even accounting for traditional CHD risk factors.